Paradoxical Vocal Motion or Vocal Cord Dysfunction

Vocal cord dysfunction is the abnormal closure of the vocal cords, which causes sudden, severe attacks of breathing difficulty. It can occur in patients of any age, although it is most common in young, healthy females. It can occur in combination with asthma or may exist alone. It is probably a reflex mechanism that the voice box uses to protect the lungs, involuntarily closing the vocal cords when exposed to any irritants.

CAUSES

The following can trigger a VCD attack:

Strong scents
Smoke
Breathing cold air
Breathing through the mouth
Laughing
Coughing
Vigorous exercise
Drinking very cold liquids

Try to avoid these triggers until the VCD is under control.

Most common associated conditions:

Asthma
Reactive airway disease or “exercise-induced” asthma
Gastroesophageal reflux disease
Allergic rhinitis

SYMPTOMS

Signs and symptoms:

Difficulty moving air in or out of lungs
Sensation of “air being cut off” or “throat closing off”
Wheezing or squeaky sounds from the throat not the lungs
Voice changes: can vary from hoarseness to aphonia (inability to speak)
Tightness or discomfort in the throat or neck
“Lump in the throat” sensation
Cough

TREATMENT

Treatment involves:

Avoiding triggers of VCD
Treating any underlying disorders (asthma, GERD, allergies)
Exercises to promote vocal cord relaxation

Treatment of underlying disorders:

Controlling asthma with preventative and rescue inhalers
Avoiding exercise-induced VCD by starting to exercise slowly, with “warm-ups” and using nasal inhale, oral exhale breathing
Controlling any acid reflux with medication
If you don’t have symptoms of acid reflux, you may have “silent reflux,” or laryngeal reflux; it is very important that you take the medication prescribed by your doctor
Avoiding acid stimulants like caffeine, alcohol, tobacco, spicy foods, chocolate, and eating before exercising or before going to bed at night
Controlling allergy symptoms with prescription or OTC medications